<!--# layout("/common/layout.html",{"jsBase":"/js/cms/insurance/"}){ -->

<form class="layui-form " id="addForm" AUTOCOMPLETE="OFF">
    <!--# include("/cms/common/basic.html",{"basic":essentialInformation}){} -->
    <fieldset class="layui-elem-field">
        <legend>健康保险</legend>
        <div class="layui-row">
            <div class="layui-form-item">
                <div class="layui-inline">
                    <label class="layui-form-label">保险公司<span style="color: red">*</span></label>
                    <div class="layui-input-inline">
                        <layui:simpleDictSelect style='layui-input-inline' type="safeCompanyType"
                                                id="safeCompany" name="safeCompany"
                                                layVerify="required"/>
                    </div>
                </div>
                <div class="layui-inline">
                    <label class="layui-form-label">保险类别<span style="color: red">*</span></label>
                    <div class="layui-input-inline">
                        <input type="text" id="insuranceCategory" name="insuranceCategory" value="${insuranceCategory}" readonly="true" lay-verify="required" class="layui-input input-readonly">
                    </div>
                </div>
            </div>
        </div>
        <div class="layui-row">
            <div class="layui-form-item">
                <div class="layui-inline">
                    <label class="layui-form-label">保险开始时间</label>
                    <div class="layui-input-inline">
                        <input type="text" id="insuranceStartTime" name="insuranceStartTime" class="layui-input input-date">
                    </div>
                </div>
                <div class="layui-inline">
                    <label class="layui-form-label">保险结束时间</label>
                    <div class="layui-input-inline">
                        <input type="text" id="insuranceEndTime" name="insuranceEndTime" class="layui-input input-readonly" readonly>
                    </div>
                </div>
            </div>
        </div>
        <div class="layui-row">
            <div class="layui-form-item">
                <div class="layui-inline">
                    <label class="layui-form-label">特殊情况说明(最多100汉字)</label>
                    <div class="layui-input-inline">
                        <textarea id="specialInstructions" name="specialInstructions"   class="layui-textarea" style="width: 740px" maxlength="200"></textarea>
                    </div>
                </div>
            </div>
        </div>
    </fieldset>
    <fieldset class="layui-elem-field">
        <legend>材料信息</legend>
        <span style="color: red;margin-left: 30px;font-size: 18px">支持文件格式为：pdf,jpg,png,gif，单个文件大小不超过20M。带*号标识的对应资料必须上传，其它资料不作要求。上传文件内容请确保真实清晰、有效，不能有旋转。上传后请查看预览，正确无误后再申报提交。</span>
        <div class="layui-row">
            <label class="layui-form-label file-upload">身份证件<span style="color: red">*</span></label>
            <layui:attachment name="Idfile" batchFileUUID="${uuid()}" isNew="true" layVerify="required" bizType="User"/>
        </div>
        <div class="layui-row">
            <label class="layui-form-label file-upload">保险公司<span style="color: red">*</span></label>
            <layui:attachment name="insuranceCompanyFile" batchFileUUID="${uuid()}" isNew="true" bizType="User"/>
        </div>
    </fieldset>
    <layui:personnelsubmitButtons id="addButton"/>
</form>
<!--#} -->
<script>
    layui.use(['add'], function () {
        var insuranceAdd = layui.add
        insuranceAdd.init();
    });

    layui.use('laydate', function(){
        var laydate = layui.laydate;
        laydate.render({
            elem: '#insuranceStartTime'
            ,done: function(value, date){
                var time=$("#insuranceStartTime").val();
             $("#insuranceEndTime").val(Number(time.split("-")[0])+5+"-"+time.split("-")[1]+"-"+time.split("-")[2]);
            }
        });
    });



</script>
